The MFMU Cesarean Registry: Factors affecting the success of trial of labor after previous cesarean delivery

Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997.

Background:

Almost one million cesarean operations are performed each year in the United States. The objective of this project was to test the hypothesis that a structured collaborative effort can help participating health care organizations to reduce their cesarean delivery rates safely.



Methods:

Experts associated with the collaborative helped participant organizations to explore several categories of change concepts and to develop action plans for safely reducing their cesarean delivery rates. Over the course of one year participants attended three two-day learning sessions. In the interval between these sessions, collaborative participants communicated by weekly conference calls and a dedicated Internet site.



Results:

Of 28 participating organizations, 15 percent achieved cesarean delivery rate reductions of 30 percent or more during the 12-month period of active collaborative work. An additional 50 percent achieved reductions between 10 and 30 percent.



Conclusions:

The Healthy People 2000 goal of a cesarean delivery rate below 15 percent by the year 2000 is attainable. Clinical leadership from doctors and nurses toward the achievement of that goal is timely, ethical, and in the best interests of childbearing women in the United States. (BIRTH 25:2 June 1998)

Reducing Cesarean Section Rates Safely: Lessons from a “Breakthrough Series” Collaborative

Active management of labor: Does it make a difference?

Myth of the ideal cesarean section rate: commentary and historic perspective.

https://escholarship.org/content/qt9v27s954/qt9v27s954.pdf?t=ow47d8

Obstetric emergencies precipitated by malignant brain tumors.

With nearly one million procedures performed each year, the cesarean section is now the most common operation in the United States Yet, much controversy exists When is it and when is it not appropriate to perform a cesarean section? What is an "appropriate" cesarean section rate? Can the cesarean section rate be safely reduced? The authors answer these questions through a practical, comprehensive review of the clinical, medical-legal, social, ethical, and economic considerations involved Plus, a special chapter with specific guidelines for appropriate utilization of cesarean operations makes this book the definitive guide for the physician who must determine whether to have a patient deliver vaginally or surgically

Bruce L. Flamm

Papers

Obstetric emergencies precipitated by malignant brain tumors.

Cesarean section : guidelines for appropriate utilization

Vaginal birth after cesarean section: an appraisal of the reappraisal.